www.zgx urinary disease is a common disease affecting people's health and life, belongs to the endocrine metabolism system diseases, with high blood sugar as the main symbol, clinically appeared thirst, polyuria, polydipsia, polyphagia, fatigue, emaciation, urinary glucose and other manifestations. Diabetes mellitus is due to the absolute or relative insufficiency of insulin secretion caused by the disturbance of glucose metabolism, protein metabolism, fat metabolism and water and electrolyte metabolism.
Diabetes mellitus can develop at any age, but the average prevalence is 4.05% in people over 60 years of age.
Diabetic ketoacidosis is a critical condition of diabetes mellitus, caused by severe insulin deficiency, in which the patient's blood glucose rises abnormally, becomes dehydrated, and rapidly enters coma, shock, and respiratory failure, with a mortality rate of 10%.
(a) Ketoacidosis is a critical condition of diabetes:
When various triggers aggravate diabetes, the body's lipolysis is accelerated, and lipolysis produces fatty acids, and a large number of fatty acids are β-oxidized by the liver to produce ketone bodies, which is a general term for β?hydroxybutyric acid, acetoacetic acid, and acetone. Under normal circumstances, ketone bodies in the blood are rare, 2 mg/100 ml of blood, and ketone bodies cannot be detected in the urine. In ketoacidosis, ketone bodies in the blood are elevated above 50 mg/100 ml of blood is called ketonemia; the presence of ketone bodies in the urine is called ketonuria. Ketone bodies to acidic substances accounted for the main part, a large number of consumption of the body's reserve base, and the gradual occurrence of metabolic acidosis. When ketoacidosis occurs, the patient's symptoms of diabetes are aggravated, accompanied by the manifestations of ketoacidosis.
(2) Causes of diabetic ketoacidosis:
1. Improper treatment of diabetes mellitus: interruption of insulin treatment or inappropriate reduction of insulin dosage; sudden stopping of hypoglycemic drugs or insufficient dosage; diabetes mellitus without formal treatment.
2, infection When diabetic patients are complicated by pneumonia, urinary tract infection, gangrene and other infections.
3, improper diet binge eating or eating irregular (clean) caused by vomiting, diarrhea.
4, other After severe trauma or surgery. Pregnancy and childbirth.
(3) Clinical manifestations of diabetic ketoacidosis:
1. Early Diabetic exacerbation of phenomena such as extreme thirst, polydrinking, polyuria, generalized weakness.
2. Rapid deterioration Loss of appetite, nausea, vomiting, abdominal pain, abdominal distension. Abdominal pain is heavier, often misdiagnosed as acute abdomen. When ketoacidosis improves, abdominal pain quickly disappears.
3, mental and respiratory symptoms headache, drowsiness, irritability, deep and large breathing, exhaling can have rotten apple smell, high ketone concentration is heavy odor.
4, dehydration symptoms caused by polyuria and vomiting diarrhea. The patient has dry skin, poor elasticity, sunken eyes, apathy, and soon enters coma. Due to the loss of water and the emergence of weak pulse, lower blood pressure, cold extremities and other shock manifestations. Some patients have fever, with a temperature of 38 to 39 degrees Celsius.
5, laboratory orange check urine sugar? ～The urine glucose? , urine ketone body positive; blood glucose is significantly elevated, most 300 to 600 mg / per 100 ml of blood (16.7 mM ~ 33.3 mM / per liter of blood), a small number of up to 1,000 mg / per 100 ml of blood (55.5 mM / per liter of blood); blood ketone body increased. Other laboratory tests can be abnormal, such as an increased blood white blood cell count and decreased blood sodium, chloride, and potassium ions.
6, pay attention to other conditions caused by the coma to identify Diabetic patients in the family suddenly appeared in a coma, most of the time there may be two kinds of conditions, one is caused by ketoacidosis, the other may be hypoglycemic coma, generally in the glucose is lower than 50 mg / 100 ml per 100 ml of blood (2.8 mM / per liter of blood) when the occurrence of the performance of the pale face, cold sweat, confusion, but the breathing, heartbeat and other general conditions are still good. , heartbeat and other general conditions are still good. The patient rapidly awakens after glucose injection. In the family can not identify these two kinds of coma, should be sent to the hospital in time to check before treatment.
(D) rescue measures:
(1) application of insulin. This is the key to rescue treatment. It must be applied under the guidance of the hospital or doctor. According to the condition of subcutaneous or intravenous injection or drip ordinary insulin. Generally, 12 to 20 units can be injected subcutaneously as appropriate, and then given a static drip of 4 to 8 units per hour amount of drops, mostly within 24 hours to control the condition, at this time, other hypoglycemic drugs should be discontinued.
(2) Correct dehydration. Try to drink water orally if you can take it orally. Comatose patients should be given intravenous rehydration, infusion of 3000-6000 ml within 24 hours, heart disease or renal function is not good patient discretion to reduce the amount.
(3) comatose patients head side position, timely removal of vomit, keep the airway open and mouth clean. Oxygen inhalation is given to those with hypoxia, and antibacterial drugs are appropriately applied to those who have developed infections.
(4) Detailed records of the patient's access, such as the amount of water, food, vomiting, urine, stool, reported to the doctor, to provide a basis for diagnosis and treatment.
(5) Diabetic ketoacidosis is a complex, serious and fast-developing condition, and a variety of laboratory tests should be conducted before and after the treatment to adjust the amount of insulin, the amount and type of infusion. It is best to send the patient to the hospital emergency to avoid serious consequences.
The percentage of diabetic patients with erectile dysfunction (ED) is more than 50%. Diabetic skin lesions
References:
Diabetes mellitus is a disease characterized by disorders of glucose metabolism due to insufficient insulin secretion in the body. The onset of the disease is characterized by excessive blood glucose and the presence of urinary glucose. Its main manifestations are excessive drinking, excessive eating, excessive urination and fatigue. When the disease is serious, it can cause severe water loss, ketoacidosis, circulatory failure and coma, and even death.
Nutritional Guidelines:
I. Control Diet: The key to treating diabetes is diet. Diet control: The key to treating diabetes lies in diet control. Through dietary control, it can promote the disappearance of urinary glucose, fasting blood glucose down to normal, correct metabolic disorders, and prevent various complications. The amount of staple food needed should be measured according to the patient's weight and labor intensity. The daily staple food is not higher than 250 grams. If you feel hungry again, you can increase the amount of vegetables that are both high in fiber and can lower blood sugar, such as onions, celery, kelp, spinach and so on. Protein by-products such as soy products, milk, lean meat, etc. can be eaten, the intake of adults 1 gram per kilogram of body weight per day; pregnant women, breastfeeding, malnutrition and co-infections, 1.2 to 1.5 grams per kilogram of body weight per day; children are 2 to 3 grams per kilogram of body weight per day. Fat intake should be based on the patient's specific situation, generally 0.6 to 1 gram per kilogram of body weight per day, the total amount of about 50 to 60 grams. Obese patients should eat less fat food, not more than 40 grams per day, emaciated patients can correspondingly increase the amount of fat, but in principle not more than double the sugar. Choose all kinds of vegetable oil as cooking oil. Limit the intake of brain marrow, egg yolk, fish eggs, animal offal and other foods containing high cholesterol, in order to reduce the blood lipid content, improve blood viscosity, to prevent complications of hypertension and coronary heart disease. Because of the reduction of staple food, vitamin B1 intake will be insufficient, it is very easy to produce numbness of the hands and feet, etc., can be given to coarse grains, beans, brown rice and other foods rich in vitamin B1 consumption.
II. Dietary taboos: tobacco and alcohol are pungent and warm products, which will aggravate the patient's thirst and drinking symptoms, and should abstain from smoking and alcohol. Avoid eating sugar, including all kinds of candy, jam, candied fruit, all kinds of sweet snacks, ice cream, vermicelli, lotus root powder, potatoes, carrots and other foods with high sugar content, which can effectively prevent the blood sugar from increasing and reduce the occurrence of complications. Avoid eating onion, ginger, garlic and other spicy and stimulating products. Diet should be less salt and light, eat more fresh vegetables, such as winter melon, green beans, wolfberry head, marjoram and so on. Sugar-lowering milk powder has the effect of lowering blood sugar, usually can be taken, 25 grams per time, warm boiled water.
III. Combination of work and rest: general patients can participate in normal work, but should not be overworked. To abstain from sexual intercourse. Keep your spirit optimistic and avoid mental trauma. Exercise can enhance tolerance to sugar and reduce dependence on insulin, reduce insulin requirements, reduce blood sugar, improve lipid metabolism abnormalities. Proper exercise can control obesity. Choose jogging, walking, practicing eighteen methods, fitness exercises, tai chi and other programs, from a short period of time, small amount of exercise to start, and persevere. But fasting and severe diabetics should not exercise to prevent hypoglycemic shock and other diseases.
IV. Urine sugar self-test: should master the urine sugar self-test method. Equipment only need to add an alcohol lamp, glass test tubes, droppers, long-handled wooden clamps and test tube brush each one, a bottle of compound copper sulfate solution (also known as the spot's reagent), a number of 95% alcohol.
Operation first with a dropper to take 20 drops of reagent in the test tube, and then add 2 drops of the patient's urine shaking, wooden clamp clamp the test tube, test tube tilted at 45 degrees, the bottom of the test tube placed on the alcohol lamp to heat and boil for 1 minute, cooled down to observe the color of the liquid in the test tube changes. If still blue is negative for urine sugar, suggesting that there is no sugar in the urine. If green is "+", there are traces of sugar in the urine; yellowish green is "+ +"; earthy yellow is "+ + +"; reddish brown is "＋＋＋＋ ". From green to reddish brown, suggesting that the amount of urine sugar from less to more changes. Through self-testing, patients can self-regulate the amount of diet, know the efficacy of treatment, adjust the dose of drugs.
V. Eugenics: According to statistics, about 25-30% of diabetics have a family history.
Young men and women with a family history of diabetes should avoid marrying each other. The incidence of congenital malformations in the fetuses of diabetic women is three times higher than that of normal women
. Multiple pregnancies can precipitate diabetes. Women must have their disease largely under control before they can become pregnant and give birth.
Treatment of diabetes two methods
Tea contains sugar, has the effect of lowering blood sugar. Just by steeping the tea in cold water, you can absorb the polysaccharides in the tea. Therefore, drinking tea made with cold water can control diabetes.
Raw pig pancreas 1, first wash repeatedly with cold boiled water, and then cut into small pieces, and then wash with cold water, daily fasting swallowed 10 small pieces (about 6 grams), Chen wine to send down, served for 1 month, can cure diabetes.
Diabetes mellitus (diabetes mellitus DM for short, is sweet polyuria), diabetes mellitus is a common chronic metabolic disease. It is customary to call it "three more and one less", accompanied by fatigue, weakness, and mental disorientation, if you do not get the ideal treatment, it is easy to complicate the cardiovascular, cerebral vascular, renal, retinal and neurological chronic degeneration and a variety of infections, ketoacidosis can occur in severe cases. Even lead to disability or death, Chinese medicine called diabetes mellitus for thirst, that the onset of diabetes mellitus and "lung", "stomach" "kidney" three organs have the closest relationship, the main mechanism for kidney Yin deficiency and dryness and heat of the lung and stomach. Its main mechanism is deficiency of kidney yin and dryness and heat in the lungs and stomach, and the cause is mostly due to excessive emotions and feelings, excessive alcoholism, over-eating of sweet and fatty foods, and uncontrolled life. According to its "three more" symptoms of different degrees of severity, Chinese medicine will be divided into "three elimination" that is, more drink for the upper elimination, more food for the middle elimination, more urine for the lower elimination.
Diabetes etiology and pathogenesis The etiology and pathogenesis of diabetes is very complex, has not yet been fully elucidated, the traditional theory is related to the following factors: First, genetic factors It is recognized that diabetes is a hereditary disease, genetic research shows that the incidence of diabetes in the pedigree of relatives and relatives of non-pedigree significant difference, the former than the latter five times higher. The importance of genetic factors in the etiology of diabetes mellitus type I is 50%, while in diabetes mellitus type II the importance of more than 90%, thus causing diabetes mellitus type II genetic factors are significantly higher than diabetes mellitus type I. In recent years, diabetes mellitus type II has been recognized as a hereditary disease. In the past decade, Chinese and foreign scholars have confirmed the role of mental factors in the occurrence and development of diabetes mellitus, and they believe that the accompanying mental tension, emotional excitement and various stress states will cause a large amount of secretion of blood glucose-raising hormones, such as growth hormone, norepinephrine, pancreatic glucagon and adrenocorticotropic hormone. Third, the obesity factor is currently considered to be an important cause of obesity is diabetes, about 60% -80% of adult patients with diabetes before the onset of obesity, the degree of obesity and the incidence of diabetes is positively proportional to the basic research materials show that: with age, physical activity gradually reduced, the proportion of human body muscle and fat is also changing. Since the age of 25 to 75 years old, muscle tissue gradually decreased from 47% of body weight to 36%, while the fat from 20% to 36%, this Department of the elderly, especially obese fat in the elderly in diabetes increased significantly one of the main reasons. Fourth, the long-term intake of too much food too much diet without moderation, overnutrition, so that the original has potentially low-functioning insulin β-cells are overburdened, and induced diabetes mellitus. Now, the concept of "the more affluent life, the fuller the body, the more diabetes" has been formed at home and abroad. In recent years, with the research and understanding of diabetes mellitus continue to deepen, from molecular biology, electron microscopy ultrastructure, immunology, physiological biochemistry and other angles to control the search for the etiology and pathogenesis of diabetes mellitus and have a new understanding. Fifth, infection Juvenile diabetes and viral infection has a significant relationship, infection itself will not induce diabetes, only can make the invisible diabetes to become obvious. Sixth, pregnancy Experts found that the number of pregnancies is related to the onset of diabetes, multiple pregnancies are prone to make genetic factors weakened to induce diabetes. Genetic factors At present, science believes that diabetes is caused by several kinds of genetic damage: Type I diabetes --- HLA-D gene damage on the short arm of the sixth pair of human chromosomes; Type II diabetes --- insulin gene, insulin receptor gene, glucose receptor gene and mitochondrial gene. lysin gene and mitochondrial gene damage. In short, regardless of the type of diabetes, whether it develops due to genetic predisposition, or environmental factors, or viral infections, it all boils down to genetic damage. In other words diabetes is a genetic disease. The blacklist of genes that cause diabetes has been written into the fourth edition of the College of Medicine's Duke Book of Internal Medicine, 1996. Diabetes mellitus is clinically divided into two types: 1, insulin-dependent diabetes mellitus (i.e., type I diabetes mellitus) Mostly occurs in the age of 30 years old, but can also be in adulthood or even old age, this type of patients start later, the condition is more serious, easy to ketoacidosis, the serious coma some patients through insulin treatment, pancreatic β-cell function has a varying degree of improvement. Individual patients can even do without insulin treatment for a period of time. 2, non-insulin-dependent diabetes mellitus (i.e., type II diabetes mellitus) Mostly occurs in adults or the elderly, patients with a slower onset of disease, milder, more obese, blood insulin levels can be slightly low, normal or high, type II diabetes mellitus is very high, accounting for about 90% of the number of people suffering from diabetes mellitus. What are the symptoms of diabetes? Typical symptoms are "three more and one less": excessive urination, excessive drinking, excessive eating and weight loss. In addition to the three more and one less, there are the following conditions for timely examination and diagnosis:
1, 2-3 hours after meals or before lunch and dinner often panic, fatigue, sweating, dizziness, hunger and other symptoms 2, often occurring skin septic infections 3, women of childbearing age have a history of multiple miscarriages, fetal anomalies,, giant fetuses, excessive amniotic fluid, etc. 4, female 4, women with recurrent urinary tract infections and frequent vulvar itching 5, men with impotence 6, unexplained limb heaviness, numbness, calf pain, or painful spasms 7, sudden vision loss of unknown cause 8, elderly people with unexplained coma, hypertension, coronary artery disease, etc. 9, unexplained necrosis of the limbs 10, premature arteriosclerosis and high blood pressure 11, weakness, emaciation, unexplained growth retardation, etc. Why urban diabetes? Why is the incidence of diabetes higher in urban than in rural areas? Why is the incidence of diabetes higher in urban than in rural areas? Urban residents have higher incomes and may consume more fat and sugar than those in rural areas. There is less physical labor, more obese people, and more stress in all aspects, resulting in more chances of diabetes development. On the other hand, urban diabetics, due to superior medical care, environment, self-maintenance and other factors, diabetic life expectancy is extended, and the opportunity to carry certain recessive genetic diseases is also increased, so the incidence of diabetes in the city than in the countryside. Six complications of diabetes In human diseases, by a chronic disease and lead to a variety of diseases, diabetes is the first. According to China's statistics, diabetes caused by the heart, brain, liver, lungs, kidneys, eyes, limbs, skin, nerves and other acute or chronic complications amounted to more than 80 kinds. We in the clinical common, and to the patient's body and mind caused great pain in the chronic complications, there are the following: 1, diabetic cardiovascular and cerebrovascular disease. Diabetic patients are often accompanied by high blood lipids, hypertension, atherosclerosis, and are very susceptible to cardiovascular and cerebrovascular disease. Diabetic heart disease usually refers to diabetic patients with concomitant or associated coronary atherosclerotic heart disease, diabetic cardiomyopathy, to microangiopathy, cardiac rhythm and cardiac dysfunction caused by vegetative nerve dysfunction. 2, diabetic nephropathy Diabetic nephropathy is an extremely serious disease for diabetic patients. The lesions can involve renal blood vessels, glomeruli, tubules, and interstitium. The common kidney damage is diabetic glomerulosclerosis, small arterial nephrosclerosis, pyelonephritis, renal papillary necrosis, and urinary protein. Among them, diabetic glomerulosclerosis is a renal complication specific to diabetes mellitus, which is commonly referred to as diabetic nephropathy in clinical practice. Diabetic nephropathy is an important cause of death in diabetic patients. 3. Diabetic eye disease. Diabetes mellitus is complicated by seven common eye diseases: diabetic retinopathy, diabetic uveopathy, diabetic cataract, diabetic optic nerve changes, diabetic retinal lipemia, diabetic glaucoma, diabetic refractive changes. The most common of these is diabetic retinopathy, which is an important cause of diabetic blindness, followed by diabetic cataract, the most common comorbidity of diabetes that destroys vision. Diabetic neuropathy Diabetic neuropathy is a general term for a variety of diabetic lesions that occur in the nervous system. It covers the vegetative nervous system, central nervous system, motor nervous system, peripheral nervous system and so on. Diabetic peripheral neuropathy is the most common complication of diabetes mellitus. Peripheral neuropathy is divided into polyneuropathy and peripheral neuropathy. The lesions may be unilateral, bilateral, symmetrical or asymmetrical. The prominent manifestations are numbness, swelling and pain in both lower limbs, accompanied by pins and needles, burning-like abnormal sensation, which is hard to endure. Some patients may have spontaneous pain flash-like pain or cut-like pain. 5, diabetic sexual dysfunction Most diabetic patients have impotence, premature ejaculation, low libido, menstrual disorders and other sexual dysfunctions, which can occur at the same time with diabetes symptoms, but most of them appear after diabetes symptoms. It is believed that the effect of diabetes on sexual function may be related to vascular lesions and pelvic plant neuropathy. 6. Diabetic lower limb gangrene Diabetic lower limb gangrene, due to diabetes mellitus is not well controlled for a long time, atherosclerosis occurs, and pathological changes of lower limb macrovascular and microvascular appear. The mechanism of his occurrence is: when atherosclerosis occurs in the lower limbs of diabetic patients, the endothelial cells of the blood vessels are damaged, the aggregation function of the red blood cells and platelets in the blood is enhanced, which makes the blood in a hypercoagulable state and prompts the formation of thrombus, causing the narrowing of lumen so that the blood vessels are blocked, resulting in the ischemia of the lower limbs or the middle part of the limbs and the lack of oxygen in order to the occurrence of gangrene.
What is gestational diabetes? What are the characteristics of gestational diabetes? Gestational diabetes mellitus refers to the occurrence or discovery of diabetes during pregnancy, pre-pregnancy diabetes pregnant women are not included, the incidence of which is about 1% - 2% of pregnant women, diabetes mellitus found to be reduced during pregnancy should also be treated as diabetes mellitus. Gestational diabetes mellitus has the following characteristics: 1, diabetes mellitus or impaired glucose tolerance was not found before pregnancy. 2, the effect of gestational food diabetes on the fetus to spontaneous abortion, fetal death in utero, preterm delivery and perinatal death is common, delivery of huge children more.
Secondary diabetes?
According to the different causes of diabetes, clinical causes, clinically divided into primary diabetes and secondary diabetes:
Secondary diabetes can be divided into:
① Pancreatic diabetes
② Endocrine diabetes
③ Diabetes caused by drugs or chemicals
④ Blood erythrocyte hyperplasia
④ Blood erythrocytes.
What are the types of diabetes mellitus?
According to the different causes and clinical manifestations, diabetes is divided into four types:
1. Insulin-dependent (type I)
2. Non-insulin-dependent (type II)
3. Nutritional deficiencies related
4. Secondary diabetes
What is diabetes mellitus
Diabetes mellitus (Diabetes mellitus). Diabetes mellitus) is a syndrome characterized by persistent hyperglycemia as its basic biochemical feature.
Diabetes occurs when the metabolism of sugar, protein, and fat in the body is disturbed due to inadequate supply of insulin or the failure of insulin to perform its normal physiological role in target cells for various reasons.
With the prolongation of diabetes, the metabolic disorders in the body, if not well controlled, can lead to chronic complications in the eyes, kidneys, nerves, blood vessels and heart and other tissues and organs, resulting in blindness, gangrene of the lower limbs, uremia, stroke or myocardial infarction, and even life-threatening.
Diabetes is a common disease, with the improvement of living standards, the incidence of diabetes is increasing year by year. The prevalence of diabetes in developed countries has been as high as 5-10%, and the prevalence of diabetes in China has reached 3%.
Body Mass Index (BMI)
Body Mass Index (BMI): A measure of a person's weight based on weight and height.
The formula is: BMI = weight in kilograms / height in meters squared.
Normal value: 20 to 24; if the BMI is greater than or equal to 27 for men and 25 for women, it is considered obese.
Abnormal Glucose Tolerance (IGT)
Abnormal Glucose Tolerance (IGT): is a condition in which some people have a fasting blood glucose that does not reach the concentration needed to diagnose diabetes but is between normal and diabetic on an oral glucose tolerance test.
These patients are not yet diagnosed with diabetes, but have a higher risk of developing diabetes later in life, as well as a higher incidence of atherosclerosis, electrocardiographic abnormalities, and mortality than the general population, and are an important part of diabetes research.
Causes of Diabetes Mellitus
The causes of diabetes are complex, but ultimately they are due to an absolute or relative lack of insulin, or insulin resistance. Thus, diabetes can be caused by problems in any of the three steps: production of insulin by B cells, delivery of insulin by the circulatory system, and receipt of insulin by target cells to fulfill their physiological role.
1. Islet B-cell level
Type 2 diabetes can occur when B cells synthesize mutant insulin due to a mutation in the insulin gene or when the insulinogen synthesized by B cells is structurally altered and cannot be hydrolyzed by proteases. And if the B cells are destroyed by an autoimmune response or chemicals, the number of cells is significantly reduced, and little or no insulin is synthesized, type 2 diabetes occurs.
2. Blood delivery levels
Diabetes can be caused by an increase in anti-insulin substances in the blood. These antagonistic substances can be antibodies to the insulin receptor, and after the receptor binds to it, it can no longer bind to insulin, and thus insulin fails to act physiologically. Hormonal substances can also counteract the action of insulin, such as catecholamines. Cortisol can raise blood sugar when its concentration in the blood is abnormally high.
3. Target cell level
Decrease in the number of receptors or decrease in the affinity of receptors for insulin and defects in receptors can cause insulin resistance, compensatory hyperinsulinemia. Eventually, there is a gradual exhaustion of B cells and a decrease in plasma insulin levels. Insulin resistance plays an important role in the pathogenesis of type 2 diabetes. Diagnostic criteria for diabetes mellitus developed by the World Health Organization in 1985
Diabetes mellitus is diagnosed on the basis of blood glucose and clinical symptoms.
Diagnostic criteria for diabetes mellitus developed by the World Health Organization in 1985
Diabetes mellitus is diagnosed when one of the following is met:
. Typical symptoms of diabetes, with blood glucose higher than 11.1 mmol/L (200 mg/dL) at any given time.
． Fasting blood glucose above 7.8 mmol/L (140 mg/dL) on two or more occasions when checked.
． Fasting blood glucose does not exceed 7.8 mmol / liter, suspected of diabetes, can do oral glucose tolerance test, 2 hours after taking sugar blood glucose more than 11.1 mmol / liter. If there are no symptoms of diabetes, another blood glucose over 11.1 mmol/l is required.
These blood glucose values are venous plasma glucose concentrations.
Diabetes China
Characteristics of common types of diabetes
Type 1 diabetes
Type 1 diabetes, previously known as insulin-dependent diabetes mellitus, accounts for about 10% of all diabetic patients, and often occurs in children and adolescents, but it can occur at any age, and can even occur at the age of 80 to 90 years. The etiology is due to cell-mediated autoimmune destruction of pancreatic islet B cells, which are unable to synthesize and secrete insulin on their own. A variety of autoantibodies can be present in the serum at the onset of the disease. type 1 diabetes is more pronounced at the onset of diabetes and is prone to ketosis, i.e., ketoacidosis tends to occur, and is dependent on exogenous insulin for survival, which is life-threatening once insulin therapy is discontinued. After receiving insulin therapy, the function of pancreatic islet B-cells improves, the number of B-cells increases, clinical symptoms improve, and the amount of insulin can be reduced, which is the so-called "honeymoon period", and it can last for several months. This is the so-called "honeymoon period", which can last for a few months. After that, when the disease progresses, it is still necessary to rely on external insulin to control blood glucose levels and curb ketone body production.
Type 2 diabetes
Type 2 diabetes, previously known as non-insulin-dependent diabetes mellitus, accounts for about 90% of all diabetic patients, with the majority of cases occurring after the age of 35. The onset of the disease is slow and insidious, and some patients are found during health examinations or checkups for other diseases. Pancreatic islet cells secrete either more, less, or normal insulin, and the peak of secretion is shifted back. Defects in insulin receptors or post-receptors on insulin target cells play an important role in the pathogenesis.About 60% of patients with type 2 diabetes are overweight or obese. Prolonged overeating, high calorie intake, and gradual weight gain to obesity, obesity leads to insulin resistance and elevated blood glucose with no apparent tendency to ketosis. Most of the patients can control their blood glucose stably after dietary control and oral hypoglycemic drug treatment; however, there are still some patients, especially the very fat ones, who need exogenous insulin to control their blood glucose. Therefore, exogenous insulin therapy cannot be used as a differential between type 1 and type 2 diabetes.Type 2 diabetes has a clear familial predisposition and is not associated with HLA antigen frequency. There is no association with autoimmune response, and islet cell antibodies and insulin autoantibodies are not present in the serum.
Gestational Diabetes Mellitus
Diabetes mellitus in a pregnant woman that was not originally recognized as diabetes mellitus and that is detected during pregnancy, usually in the second or third trimester, is called gestational diabetes mellitus. Those who already had diabetes before pregnancy are diabetic patients gestation, known as diabetic pregnancy. After mid-gestation, and especially in the second trimester, the placenta secretes a variety of insulin-fighting hormones, such as placental lactogen, and the number of insulin receptors on the membranes of target cells decreases. Diabetes mellitus tends to appear in the second trimester. If 100 pregnant women are screened for blood glucose, approximately 3 patients with gestational diabetes can be detected. In order to detect gestational diabetes early, generally in the 24-28 weeks of pregnancy, oral glucose 50 grams, half an hour after taking glucose glucose measurement of blood glucose, if the value of blood glucose is less than 7.8 mmol / liter, it may be gestational diabetes, need to do 100 grams of glucose tolerance test for diagnosis. For gestational diabetes mellitus, blood glucose should be actively controlled to avoid the adverse effects of high blood glucose on the fetus. After 3 months of delivery, according to its blood glucose level and then do the clinical typing of diabetes, 50% ~ 70% of gestational diabetes after delivery manifested as type 2 diabetes, part of the patient glucose tolerance back to normal, only individual patients into type 1 diabetes.
China Diabetes Network
International Diabetes Federation 1997 typing program
In July 1997, the 16th International Diabetes Federation (IDF meeting) held in Helsinki, Finland, the capital of the diabetes typing program (the American Diabetes Association 1997 typing program) put forward recommendations.
I. Type 1 diabetes ---- destruction of pancreatic B-cells leading to absolute insulin deficiency.
(i) Autoimmune
Acute onset
Slow onset
(ii) Idiopathic
ii. Type 2 diabetes mellitus ---- insulin resistance predominantly with relative insulin deficiency or impaired insulin secretion predominantly with insulin resistance.
III. Other specific types
(I) B-cell function gene defects
1. Chromosome 12, hepatocyte nuclear factor HNF 1alpha (MODY3);
2. Chromosome 7, glucokinase (MODY2);
3. Chromosome 20, hepatocyte HNF 4alpha (MODY1);
4. mitochondrial DNA;
5. other.
(ii) Genetic abnormalities of insulin action
1. Type A insulin resistance;
2. Leprechaunism;
3. Rabson-Mendenhall syndrome;
4. Lipoatrophic diabetes mellitus;
5. Other
(iii) Pancreatic exocrine epidemics
1. Pancreatitis
2. Trauma or pancreatectomy
3. Tumor
4. Cystic fibrosis
5. Hemochromatosis
6. Fibrocalcific pancreatic disease
7. Other
(4) Endocrine epidemics
1. Acromegaly <
2. Cushing's syndrome
3. Glucagonoma
4. Pheochromocytoma
5. Hyperthyroidism
6. Growth inhibiting hormone tumors
7. Aldosterone tumors
8. Other
(5) Diabetes mellitus caused by drugs or chemical agents
1. Vacor (N-3-pyridinylmethyl N-P-nitrophenyl urea), a rodenticide
2. Pentamidine
3. Nicotinic acid
4. Glucocorticoids
5. Thyroid hormones
6. Diazoxide
7. β-adrenergic agonists
8. Adrenergic agonists
8. Thiazide diuretics
9. Phenytoin sodium
10. After interferon alpha therapy
11. Other
(vi) Infections
1. Congenital rubella
2. Cytomegalovirus
3. Other
(vii) Unusual immune-mediated diabetes
1. Still-man syndrome
2. Insulin autoimmune syndrome
3. Antiinsulin receptor antibodies
4. Others
(8) Other genetic syndromes with diabetes
1. Down's syndrome
2. Klinefelter's syndrome
3. 2. Klinefelter's syndrome
3. Turner's syndrome
4. Wolfram's syndrome
5. Friedreich's ****typhosis
6. Huntington's chorea
7. Lawrence-Moon-Beidel syndrome
7. Lawrence-Moon-Beidel syndrome
8. Ankylosing myasthenia gravis
9. Porphyria
10. Prader-Willi syndrome
11. Other four Gestational diabetes mellitus (GDM)
Diabetes China
Gestational diabetes mellitus exercise
Gestational diabetes mellitus should choose what kind of exercise
Gestational diabetics are advised to choose more soothing, rhythmic exercise programs, such as walking, slow swimming and tai chi, etc.; there should be a warm-up before exercise, and at the end of the end of the exercise should do some more light exercise, and gradually end; can not be strenuous exercise, such as running, ball, push-ups, skiing and so on.
China Diabetes Network
What kind of disease is diabetes, and what is the incidence in China?
Diabetes is a group of common metabolic endocrine disease, divided into primary and secondary two categories.
Primary diabetes accounts for the vast majority of cases, and can be hereditary. Its basic pathophysiology is absolute or relative insufficiency of insulin secretion, which causes metabolic disorders of sugar, protein, fat, water, and electrolytes, and often leads to acid-base balance disorders in severe cases.
It is characterized by hyperglycemia, glycosuria, reduced glucose tolerance and abnormal insulin release test. Clinically, there are no symptoms in the early stage, and there are symptoms such as polydrinking, polyphagia, polyuria, thirst, hunger, emaciation, fatigue and weakness, etc. Those who are sick for a long time are often accompanied by cardiovascular, renal, ophthalmic and neurological lesions, and in serious cases, it can cause ketoacidosis, hyperosmolar coma, lactic acidosis and life-threatening, and is often prone to complicate with suppurative infections, urinary tract infections, itching of the skin and vulva and tuberculosis, etc.
The pancreas is characterized by high glucose, low glucose tolerance and abnormal insulin-releasing test.
Insulin and antimicrobials are effective drugs to control ketosis and infection. At present, the mortality rate of this disease is decreasing year by year, and more than 70% of patients die of cardiovascular complications, but if early prevention, better control of the disease, the patient's life expectancy can be significantly prolonged, and the labor force can be